Stark: Auditors dip toes in home infusion

Friday, February 24, 2012

 As auditors wade into home infusion documentation, providers can expect to see the scope and volume of audits rise. 

"As the auditors are getting their toes in the water, they are adding more to the list," said Andrea Stark, a reimbursement consultant for MiraVista, a billing and consulting firm in Columbia, S.C.

Stark will give a presentation at the National Home Infusion Association's annual conference, held April 23-26, called, "Medicare Reimbursement Audits: Understanding the Types, Trends and How to Prepare."

What's on the audit radar? Lots, says Stark. The Office of Inspector General has its eye on pricing for enteral and parenteral nutrition, while some Recovery Audit Contractors have set their sights on additives and premix solutions. Other product categories include nebulizers, supply kits, specialty nutrients and infusion drugs.

One thing home infusion providers have going for them in an audit: solid clinical documentation, says Stark.

The trick is making sure everything is "ticked and tied," she said.

"For the most part, medical necessity is justified," said Stark. "It's just that the LCDs are so complex. They are auditing these products where there are many hoops to jump through."